04 Jun High Risk Prostate Cancer: Adjuvant Radiation May Reduce Risk of Death

MedicalResearch.com Interview with:

Dr. D’Amico

Anthony D’Amico, MD, PhD
Professor and Chief of Genitourinary Radiation Oncology
Brigham and Women’s Hospital and Dana-Farber Cancer Institute

MedicalResearch.com: What is the background for this study?

Response: 3 randomized trials published in Sept, 2020 in the Lancet and Lancet Oncology concluded that delivering radiation therapy (RT) after surgery for prostate cancer   when the PSA rises signaling recurrence (i.e. early salvage RT) as opposed to when the PSA is undetectable (i.e. adjuvant RT) did not compromise subsequent cancer progression.

However these trials may have missed the benefit of adjuvant RT because a minority of men (9 to 17% of the study cohorts) were found to have adverse factors at prostatectomy which are associated with cancer progression and death from prostate cancer.

Specifically, men with adverse pathology at prostatectomy comprise the vast majority of men who go on to die from prostate cancer and therefore have the most to gain from adjuvant RT. Yet, given the results of the 3 randomized trials many physicians are no longer offering adjuvant RT, even in men with adverse pathology at surgery.

MedicalResearch.com: What are the main findings?

Response: Our study provides evidence to suggest that delivering adjuvant as compared to early salvage radiation therapy can reduce the risk of death by decreasing death from prostate cancer in men found to have adverse pathology at surgery.

MedicalResearch.com: What should readers take away from your report?

Response: These data should heighten awareness that men with adverse pathology at surgery may experience shortened survival due to an increase in death from prostate cancer, if physicians wait for the PSA to rise to deliver RT (i.e. early salvage RT).

No disclosures 

Citation:

Adjuvant Versus Early Salvage Radiation Therapy for Men at High Risk for Recurrence Following Radical Prostatectomy for Prostate Cancer and the Risk of Death

Derya Tilki, Ming-Hui Chen, Jing Wu, Hartwig Huland, Markus Graefen, Thomas Wiegel, Dirk Böhmer, Osama Mohamad, Janet E. Cowan, Felix Y. Feng, Peter R. Carroll, Bruce J. Trock, Alan W. Partin, and Anthony V. D’Amico

Journal of Clinical Oncology 0 0:0

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Last Updated on June 10, 2021 by Marie Benz MD FAAD